Monthly Bulletin of the Alliance's Learning Health System |
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Land-Based Healing on Manitoulin Island |
| Understanding How We Work Together |
| Clinical Trials for COVID Care |
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 | Learning Events & Programs |
| | | Get Involved: Research & Sharing |
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Nature's Gifts: Strength, Community, and Health Expanding Land-Based Healing on Manitoulin Island |
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| Land-based healing is grounded in ancient Indigenous ways of knowing and being. It sees healing not as something obtained at a single point in time, through medical interventions, but as a process and a journey that incorporates the land and the environment. Nature and its gifts are sources of strength, nourishment, and community. EPIC spoke with Danielle Wilson, Executive Director of Noojmowin Teg Health Centre on Manitoulin Island, about how the Centre is expanding and formalizing its land-based healing practices. |
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Land-based healing has been practiced informally at Noojmowin Teg for a long time. It is woven into the fabric of care and incorporated into all of their health care practices. For example, clinicians take clients out on medicine walks to gather traditional medicines, and traditional healers organize programs and services in the community. Although land-based healing includes solitary, meditative time spent in nature, it is also grounded in shared activity. At Noojmowin-Teg, clients and community members come together for activities like canoeing, ice fishing, snowshoeing, and gathering wild rice. These activities can support food security, physical activity, and social connectedness. They also create opportunities for conversations about values, culture, and how to nourish and care for one’s body and mind. Often, focusing on an activity helps people open up to receive healing. As people engage in the healing journey together, they build community and learn from each other.
Now the Centre is expanding their land-based healing practices into a formal program. The decision to make this change began when they were updating their strategic plan. Consulting local partners, they heard how much the community values the Centre’s land-based activities and look to them as a tool for building resilience. They heard how local organizations want to see even more traditional activities made available to the community’s children and youth. At the same time, social prescribing was gaining traction in Ontario, and Centre staff were keen to include it in their work. They could see how well social prescribing aligns with the land-based healing they were already providing. Both approaches facilitate connectedness and peer support, and land-based healing adds the element of empowering participants to connect with and draw strength from the natural world.
All of these insights made it clear that expanding the land-based healing program was an important direction for the Centre to take. They were enabled to do this thanks to changes to the funding and reporting structures that the Indigenous Primary Health Care council had negotiated with the Ministry of Health. These changes give Indigenous primary health care providers more autonomy in choosing their programs and directing funds to them. In March 2022, Noojmowin Teg capitalized on this to hire a land-based healing coordinator, who will oversee the development and expansion of a formal land-based healing program at the Centre. The coordinator will work closely with the Centre’s child and youth workers, the Health and Wellness Coordinator, and community partners to develop new and expanded programs.
Danielle notes that the timing for this expansion is fortuitous, as COVID-related restrictions on group activities are softening and making it easier for people to gather in person. As these are early days, there’s no data to share yet. We look forward to checking in with them again in a few months to hear how the program grows and share their experiences with you. |
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| | This handpainted canoe was gifted to Noojmowin Teg and is used in some of their land-based healing programs.
Photos courtesy of Noojmowin Teg Health Centre. |
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Project RÉAC! How we found new ways to work together during the pandemic. |
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Crisis and challenge often push us towards innovation and collaboration. With the onset of the COVID-19 pandemic, community organizations and public institutions found new ways to work together to support the health of structurally vulnerable people and communities. These efforts often crossed sector lines and used emerging technologies to enable social connection with physical distance. RÉAC! is a participatory research project exploring this wave of collaboration and what lessons we can take from it beyond the pandemic. EPIC spoke with Lara Gautier, the project’s principal investigator, about this research. |
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What is Project RÉAC about?
The project team is examining 21 intersectoral initiatives that emerged to support newcomers in Ontario and Quebec who have refugee status, are seeking asylum, or don’t have immigration status. Some of the questions they’re exploring include: - Did these initiatives enable organizations to maintain continuity of service?
- How did people collaborate across sectors?
- Can new inter-sectoral links be sustained beyond the pandemic?
- How was sustainability considered in service planning?
The learnings from this study will be shared through a variety of knowledge products to inform policy and practice. These may include policy and practice briefs, lay language publications, and dissemination workshops. Specific strategies for knowledge translation will be developed with input from the project’s advisory boards, which include participating organizations and newcomer representatives.
How did the research team find and choose initiatives to study?
RÉAC! began with an open survey in which organizations were invited to share their new inter-sectoral initiatives. These initiatives were reviewed by an advisory board consisting of people from public and community organizations, as well as newcomer representatives (e.g., see the full list for Toronto here). Through a series of deliberative workshops, they narrowed the field to eight initiatives based in Toronto, eight in Montréal, and five in Sherbrooke. The final selection is available on this webpage. Each of these involves at least one partner organization from the public sector and one from the community sector. Some are specifically COVID-related (infection prevention and control, or support for vaccination) and others are focused on supporting the social and structural determinants of health in times of health crises.
Are the Alliance or its members involved?
The innovations being explored include several from the Alliance and our member organizations: - Community Vaccination Promotion Ontario (CVP-ON), a program funded by the Public Health Agency of Canada as part of a nationwide CVP program and coordinated in Ontario by the Alliance for Healthier Communities. It includes 11 Alliance-member organizations from across Ontario as well as the Canadian Association of Community Health Centres.
- Several programs led by or including Access Alliance, including Food with Dignity, Financial Awareness and Income Support, Mental Health Monday, Vaccine Engagement Teams. Partners in these programs included numerous cultural agencies, schools, volunteer organizations, restaurants, federal and provincial government agencies, Toronto Public Health, and East Toronto Health Partners, among many others.
- COVID-19 Mobile Testing Sites, with Black Creek CHC, Emery-Keelesdale Nurse Practitioner--Led Clinic, two LHINs, Toronto Medics, Ontario Health, and Toronto Public Health.
Dr. Jennifer Rayner, Director of Research and Evaluation at the Alliance is on the board, as is Cliff Ledwos, Director of Primary Health Care and Innovation at Access Alliance.
What’s next?
The next phase of the research project is to conduct 80 one-on-one interviews as well as five or six focus groups with approx. 80 participants. Interviewees will represent the health and social service providers, community agencies, funders, and government agencies that were involved in the 21 initiatives. Focus groups will be comprised of newcomers who accessed these or other services during the pandemic. While they are prioritizing those who accessed the services they’re studying, the research team recognizes that there may be barriers to finding them, so they are opening up the focus groups to any adult newcomer (who came with refugee status, were seeking asylum, or didn’t have immigration status) who was living in Montreal, Toronto or Sherbrooke during the pandemic. To lower barriers to participation, they are offering both online and in-person options for participation. Compensation is also offered to each newcomer participant in the form of a $60 Walmart gift card.
Data collection will continue through much of the summer and fall. Data analysis will begin in late fall or early winter, and preliminary findings will be shared with the advisory board and research participants then.
My organization works with newcomers. How can we help with recruitment?
Participation is open to anyone over 18 who arrived in Canada between 2016 and 2022 and has experienced life here during the COVID-19 pandemic. People who arrived with the status of asylum seeker, refugee or migrant without status is welcome, even if they have since had a change of status.
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Evaluating Interventions for COVID-19 Alliance is a key player in a new $10M pan-Canadian study. |
A new, $10 million grant has just been announced by the Canadian Institutes of Health Research (CIHR) for an exciting research project about treating COVID-19 in primary care and other outpatient settings. Dr. Jennifer Rayner, our Director of Research and Evaluation, is a co-investigator. The Alliance's Practice-Based Learning Network (PBLN), will be an avenue for recruitment along with other members of the POPLAR Network.
Can-ADAPT COVID brings together a team of over 50 researchers from partner organizations across Canada, including the Alliance for Healthier Communities. The pan-Canadian research team aims to enroll up to 12,000 participants from across Canada. Linked EMR data from 13 primary care networks, including POPLAR, will be used to proactively identify and reach clients who have a diagnosis of COVID-19 and are at moderate to high risk of progression to severe COVID outcomes, to potentially participate in the trial. This data will also support the evaluation of each intervention. The research team will include patient partners from each participating province, whose perspectives will be meaningfully embedded throughout the project.
Can-ADAPT COVID will test different oral COVID-19 treatment options suitable for use in a non-hospital setting. The name stands for Canadian ADAptive Platform Trial of COVID-19 Therapeutics in Community Settings. Adaptive platform trials (APTs) are randomized clinical trials designed to compare multiple therapies at once and study new medications as they emerge. This makes it particularly well-suited to the current context, where new treatments for a new illness are being continually developed, and our understanding of the illness is also evolving. Treatments will be chosen through the Canadian COVID-19 Therapeutics Advisory Panel, based on scientific evidence, supply, and scalability. This APT will evaluate interventions in terms of: - Rate of hospitalization or death at 28 days from symptom onset
- Time to recovery
- Symptom severity
- Health service use, treatment costs, and value
- Quality of life
- Occurrence of long COVID
- Early discontinuation and other safety data
This fall, participants will be recruited through primary health care providers and in other health care and community settings, such as emergency departments, infectious disease outpatient clinics, community organizations, as well as through social media and public advertisements. Baseline health data and ongoing data about health system usage, will come from the primary care networks and provincial health databases. Sociodemographic data will be collected from each participant at baseline. Patient-reported outcome data will be collected throughout via an online daily diary or regular phone calls (for those without access to internet) and by survey. All participants will be compensated for their time and effort. In addition to advancing knowledge about the value of various COVID-19 treatments, the project aims to enhance community engagement, build capacity for research, and ensure that the research is focused on what matters most to people and communities. The team hopes to hold a summer institute in 2023 for emerging health researchers. Patient partners and health care providers will help them develop tools and resources to help people use and apply what is learned. Community engagement specialists will be brought on board to help with tailoring recruitment materials and activities and to support local knowledge translation, in order to ensure that these are accessible and culturally appropriate for diverse populations.
Our sector's involvement in this trial is a significant landmark and a huge gain for health equity in Ontario. For too long, our members' clients were excluded from large-scale trials such as this one, because their primary care data was not included in provincial datasets. Because our practice data is now standardized, collected, and shared with CIHI and ICES, it is included in linked datasets. This means studies like this one can evaluate how effective various medical interventions are for people in in Ontario who experience the most significant barriers to health and wellbeing. |
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Learning Events & Programs |
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POPLAR Webinar Series: EDIIA in Research
Part 1: Embedding Equity in Leadership & Teams Monday, July 25, 2022, 12-1 pm | Dr. Nicole Kaniki, University of Toronto Part 2: Building Research Projects with an EDIIA Lens Friday, August 26, 2022, 12-1 pm | Dr. Vivian R. Ramsden, University of Saskatchewan Part 3: FNIM data and Indigenous data sovereignty Wednesday, September 21, 2022, 12-1 pm | Sujitha Ratnasingham, ICES
Part 4: EDIIA and Data - Building Capacity Wednesday, October 19, 2022, 12-1 pm | Dr. Andrew Pinto, Upstream Labs
POPLAR’s vision is to advance equitable primary healthcare delivery and health outcomes for everyone in Ontario. We aim to embed EDIIA principles in all our activities. This ongoing learning journey requires self-awareness, reflection, and action. We are committed to developing approaches to leadership, research, data collection, knowledge mobilization, knowledge translation, and data management that are in keeping with EDIIA. Join us in our journey.
September
September 22 & 23. NPAO Annual Conference. This year's conference will be held in person. The theme is The NP Experience: Pushing Boundaries Towards Common Goals. Registration and program here.
October
October 3-7, 9:00-10:30 am daily. Virtual Learning Event for Privacy Officers. This is the Alliance's seventh annual professional learning event for privacy officers. Join us for five one-hour presentations over five consecutive days. Each one is followed by an optional 30-minute networking session. Details and registration link here.
October 12. AFHTO 2022 Conference. The Association of Family Health Teams of Ontario's 2022 conference is a hybrid in-person/virtual event on the theme of Reconnect and Reimagine: Moving Forward Together. Registration opens soon; watch this page for updates.
Thursday, October 20. Save the date for our virtual Social Prescribing conference! The Alliance for Healthier Communities is hosting a one-day virtual conference, showcasing current practices in Social Prescribing from many perspectives and on many topics. Stay tuned for more! For more information or to apply to present, please contact Natasha Beaudin, Social Prescribing Project Lead (Natasha.Beaudin@allianceON.org) or Josephine Pham, Social Prescribing Knowledge Mobilization Specialist (Josephine.Pham@allianceON.org). |
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Research & Sharing Opportunities |
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Clinical Trials & Studies
Who "deserves" access to health care? Researchers at York University are studying how health care advocates help individuals with precarious immigration status to navigate Ontario's health care system. They're looking for individuals who have experience living without citizenship in Ontario and those who work as service providers community organizers. For more information, contact Sarah Marshal at SMarsh4@my.yorku.ca.
Primary care clinicians needed to help guide a research project about care for clients with dementia. A research team from Dalla Lana school of Public Health are planning a study into what enables effective communication with clients who have mild cognitive impairment (MCI) or early-stage Alzheimer disease or related dementia (ADRD). They're currently looking for a family physician or nurse practitioner to join the project's steering committee. For more information, please email Allie Peckham (Allie.Peckham@asu.edu).
Does your organization provide health care or other supports to refugees and asylum seekers? Researchers at the University of Calgary are looking for people working in clinical, public health, or settlement organizations to answer some questions via an online survey. They want to understand who provides care to refugees and asylum seekers in Canada, how this care is coordinated and delivered, how it differs among jurisdictions, and how COVID-19 has impacted it. Participate by completing this short survey. In lieu of an honorarium, the research team will donate $10 to support refugee student scholarships. See flyer (English or French) for more information.
How have newcomers to Canada experienced health and social care from community organizations since the beginning of the pandemic? RÉAC! Responsive services for newcomers in the context of the COVID–19 pandemic is a study led by researchers in Quebec and Ontario who are exploring this question. They are looking for newcomers (arrived 2016 or later) who are refugees, asylum seekers, or without status to participate in discussion groups. Participants will be compensated. See story above and the project website for more information.
Urban health care organizations: How have you incorporated health equity into virtual care? A team of researchers from Women's College Hospital is conducting case studies of health equity and virtual primary care across Canada. If you'd like more information or are interested in participating, contact the research coordinator at Simone.Shahid@wchospital.ca.
Do you have older adult clients who are experiencing loneliness? A research team at Baycrest is studying the use of a virtual, at-home program aimed at promoting brain health. Participants will engage in either mindfulness meditation or brain training for 8 weeks and complete online sessions and surveys to assess the impact of the interventions. Compensation will be provided. To be eligible, participants must be over 60 years of age, living in Ontario, and have access to a mobile device or computer with an internet connection. Full details and contact information here. Register here.
Need help with client engagement and communication? Get access to the Canadian Primary Care Information Network (CPIN), tailored messages for your vaccine-hesitant clients, and up to three additional communications and survey campaigns on topics of your choice. Family physicians at the University of Ottawa and Monfort Hospital are studying how automated patient engagement systems like CPIN can improve communications with clients about COVID-19 vaccines. Get more information here or email the study team at info@cpin-rcip.com.
Social workers in primary health care: What has your daily practice looked like during the COVID-19 pandemic? Dr. Rachelle Ashcroft from the University of Toronto is leading a mixed-methods study called The Structure of Social Work Practice in Ontario Primary Care Teams. Participants will be asked to complete a survey about the role of social work, the current and optimal state of practice, and social work leadership. At the end, participants can optionally sign up for focus group. For more information, contact Rachelle Ashcroft at Rachelle.Ashcroft@utoronto.ca.
Collaborative Learning
SPIDER Learning Collaborative: De-prescribing dangerous medications. Can data-driven QI activities help de-prescribe potentially harmful medications, for medically complex senior clients? Help answer this question and improve health outcomes for your clients by participating in a 12-month learning collaborative. EMR queries will be provided to help participating Alliance members identify clients who would benefit. Contact Jennifer Rayner for more information. |
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Funding Available
Is your organization is new to research? Up to $10K is available from the Canadian Institutes of Health Research to help plan, implement, evaluate, scale, or spread programs that support LGBTQIA/2S health and wellbeing. To be eligible, your organization must have no prior research experience or be the current recipient of a grant from the same program. Projects must have an intersectional lens. More information here. Application deadline: August 30, 2022. Training and Learning Resources
Governing for Health Equity. This five-part, self-paced online course was created by the Alliance to help boards go beyond diversity and inclusion, and build organizations that are better equipped to advance health equity at every level in the organization, the community, and the health system. Discounts for Alliance members and health equity builders. Register here.
Rainbow Health Ontario's Online Learning Platform: LGBT2SQ Health Connect includes online courses on delivering safe and affirming care, a Trans health knowledge base, clinical resources, research opportunities, brochures and publications, and more.
learn more and sign up your team.
Foundations of Indigenous Cultural Safety (ICS): This is the first course in the Anishnaabe Mino'ayaawin - People in Good Health ICS Training program from the Indigenous Primary Health Care Council. This course has been created for individuals working in the health care system to learn the importance of adopting culturally safe and appropriate practices when serving Indigenous clients and patients. This training will be hosted online and will take users approximately three hours to complete. Cost is $175 per person. For more information and to begin the registration process, please email ics@iphcc.ca.
Toolkits New resource to help you provide even better virtual care. Regardless of your level of experience providing virtual care, this new toolkit from Canada Health Infoway and Healthcare Excellence Canada can support your efforts to make it safer, more effective, and more accessible. It contains information synthesized from existing resources and tools, tested and refined by 25 teams from across Canada through the Virtual Care Together Design Collaborative. Topics covered include: - Appropriate use of virtual care
- Quality and safe virtual care interactions
- Use and optimization of virtual care
New resources to support affirming care for 2SLGBTQ+ families. Precarious Inclusion is a research project from the University of Guelph, grounded in the voices and living experiences of 2SLGBTQ+ families in Ontario, and designed to help client-facing staff provide more inclusive and affirming service in various settings. Resources created through the project include a reel of short videos in which families tell their stories, plus a series of infographic tip sheets, including two created specifically for staff in health care and social services. For more information about the project or to access the video reel or free printed copies of the tip sheets, email Dr. Julia Gruson-Wood, at JGrusonW@uoguelph.ca.
In Case You Missed It: Recorded Webinars
The Ins & Outs of Optimizing Panel Size: A WEQI Approach (May 17). Two leaders from the West End Quality Improvement (WEQI) collaborative share their experiences and learnings with applying quality improvement (QI) methodology to the complex challenge of optimizing their panel sizes. Video recording and slide deck here.
Gender-Affirming Cancer Screening Guidelines for Transgender and Non-Binary Clients (June 17). A special webinar about the newly updated policy from Ontario Health on breast and cervical cancer screening for Trans and Non-Binary clients. Guests from Ontario health and Alliance member organizations shared an overview of these guidelines and how to implement them, as well as presenting a number of other resources that can help make cancer screening safer and more accessible to Transgender and Nonbinary clients and community members. See the recording, slide deck, and other resources here.
Bite-Sized Info Sheets about Comprehensive Primary Health Care: Now in French!
Looking for more?
To get the most updated information from an Indigenous lens on the most recent news releases and updates, please subscribe to the Indigenous Primary Health Care Council bi-weekly newsletter! In it you will find CEO updates, member spotlight for upcoming events, IPHCC program updates alongside helpful resources and opportunities to learn from. To subscribe or to contribute to the content, please contact afasihuddin@iphcc.ca or abarlow@iphcc.ca.
Linkages is a monthly e-Newsletter from The Centre for Studies in Aging & Health (SCAH) and the Seniors Health Knowledge Network (SKHN). Each issue brings you a new reading list, links to events and other resources, and the latest news from CSAH, SHKN, and their collaborators. Subscribe here. |
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